The development of a new measure of quality of life for children with congenital cardiac disease

The purpose of the study was to develop a questionnaire measuring health-related R1 quality of life for children and adolescents with congenital heart disease, the ConQol, that would have both clinical and research applications. We describe here the process of construction of a questionnaire, the piloting and the development of a weighted scoring system, and data on the psychometric performance of the measure in a sample of 640 children and young people recruited via 6 regional centres for paediatric cardiology from across the United Kingdom. The ConQol has two versions, one designed for children aged from 8 to 11 years, and the other for young people aged from 12 to 16 years. Initial findings suggest that it is a valid and reliable instrument, is acceptable to respondents, and is simple to administer in both a research and clinical context

Kaposi's sarcoma in a patient with erythroblastopenia and thymoma: Reactivation after topical corticosteroids

We report a 69-year-old female with erythroblastopenia and thymoma who developed lesions of Kaposi's sarcoma (KS) after thymectomy, 2 months after the initiation of therapy with methylprednisolone. Control of mucocutaneous KS lesions was obtained with radiotherapy, interferon alfa-2b and withdrawal of systemic immunosuppressive therapy. Erosive oral lichen planus appeared later, and after therapy with topical corticosteroids a new lesion of KS developed that regressed after withdrawal of topical corticosteroids. The detection of HHV-8 only in lesional skin supports the hypothesis that this virus can trigger the development of KS lesions

Sensitive Detection and Early Prognostic Significance of p24 Antigen in Heat-Denatured Plasma of Human Immunodeficiency Virus Type 1-Infected Infants

Immune complex formation causes underdetection of p24 antigen in human immunodeficiencyvirus(HIV)infection.Brieflyboilingdilutedplasma releasesallcomplexedantigen, which can then be measured by some commercial assays. In a retrospective pediatric cohort study, the specificity of this procedure in 390 uninfected samples was 96.9% after initial testing and 100% after neutralization. Sensitivity among 125 postnatal infected samples was, at a detection of 2 pg/ml., 96.0% (97% neutralizable) compared with 47.7% for regular antigen (76% neutralizable), 96% for polymerase chain reaction, and 77% for viral culture. The high sensitivity and specificity of heat-denatured antigen was confirmed by prospectively testing 113 additional samples.Quantitativeanalysisofsamplesfrominfectedinfants showedlowlevelsofp24 antigen in 29% of cord blood sera, a postnatal increase to levels that were during the first 6 months of life inversely associated with survival, and persistence of antigenemia thereafter independent of clinical status. Prevalence and antigen levels were significantly lower in mothers. The persistent antigenemia in children indicates that their immune systems cannot restrict HIV expression as efficiently as those of adult

The Control System for a new Pixel Detector at the sLHC

For the upgrade of the LHC, the sLHC (super Large Hadron Collider), a new ATLAS Pixel Detector is planned, which will require a completely new control system. To reduce the material budget new power distribution schemes are under investigation, where the active power conversion is located inside the detector volume. Such a new power supply system will need new control strategies. Parts of the control must be located closer to the loads. The minimization of mass, the demand for less cables and the re-use of the outer existing services are the main restrictions to the design of the control system. The requirements of the DCS (Detector Control System) and a first concept will be presented. We will focus on a control chip which necessarily has to be implemented in the new system. A setup of discrete components has been built up to investigate and verify the chip’s requirements. We report on the status of the work

Dynamical elastic bodies in Newtonian gravity

Well-posedness for the initial value problem for a self-gravitating elastic body with free boundary in Newtonian gravity is proved. In the material frame, the Euler-Lagrange equation becomes, assuming suitable constitutive properties for the elastic material, a fully non-linear elliptic-hyperbolic system with boundary conditions of Neumann type. For systems of this type, the initial data must satisfy compatibility conditions in order to achieve regular solutions. Given a relaxed reference configuration and a sufficiently small Newton's constant, a neigborhood of initial data satisfying the compatibility conditions is constructed

On the propagation of jump discontinuities in relativistic cosmology

A recent dynamical formulation at derivative level \ptl^{3}g for fluid spacetime geometries $({\cal M}, {\bf g}, {\bf u})$, that employs the concept of evolution systems in first-order symmetric hyperbolic format, implies the existence in the Weyl curvature branch of a set of timelike characteristic 3-surfaces associated with propagation speed |v| = \sfrac{1}{2} relative to fluid-comoving observers. We show it is the physical role of the constraint equations to prevent realisation of jump discontinuities in the derivatives of the related initial data so that Weyl curvature modes propagating along these 3-surfaces cannot be activated. In addition we introduce a new, illustrative first-order symmetric hyperbolic evolution system at derivative level \ptl^{2}g for baryotropic perfect fluid cosmological models that are invariant under the transformations of an Abelian $G_{2}$ isometry group.Comment: 19 pages, 1 table, REVTeX v3.1 (10pt), submitted for publication to Physical Review D; added Report-No, corrected typo

How do Zimbabweans value health states?

Background Quality of life weights based on valuations of health states are often used in cost utility analysis and population health measures. This paper reports on an attempt to develop quality of life weights within the Zimbabwe context. Methods 2,384 residents in randomly selected small residential plots of land in a high-density suburb of Harare valued descriptors of 38 health states based on different combinations of the five domains of the EQ-5D (mobility, self-care, usual activities, pain or discomfort and anxiety or depression). The English version of the EQ-5D was used. The time trade-off method was used to determine the values, and 19,020 individual preferences for health states were analysed. A residual maximum likelihood linear mixed model was used to estimate a function for predicting the values of all possible combinations of levels on the five domains. The model was fit to a random subset of two-thirds of the observations, with the remaining observations reserved for analysis of predictive validity. The results were compared to a similar study undertaken in the United Kingdom. Results A credible model was developed to predict the values of states that were not valued directly. In the subset of observations reserved for validation, the mean absolute difference between predicted and observed values was 0.045. All domains of the EQ-5D were found to contribute significantly to the model, both at the moderate and severe levels. Severe pain was found to have the largest negative coefficient, followed by the inability to wash and dress oneself. Conclusion Despite a generally lower education level than their European counterparts, urban Zimbabweans appear to value health states in a consistent manner, and the determination of a global method of establishing quality of life weights may be feasible and valid. However, as the relative weightings of the different domains, although correlated, differed from the standard set of weights recommended by the EuroQol Group, the locally determined coefficients should be used within the Zimbabwean context

Mitochondrial genomes of giant deers suggest their late survival in Central Europe

The giant deer Megaloceros giganteus is among the most fascinating Late Pleistocene Eurasian megafauna that became extinct at the end of the last ice age. Important questions persist regarding its phylogenetic relationship to contemporary taxa and the reasons for its extinction. We analyzed two large ancient cervid bone fragments recovered from cave sites in the Swabian Jura (Baden-Württemberg, Germany) dated to 12,000 years ago. Using hybridization capture in combination with next generation sequencing, we were able to reconstruct nearly complete mitochondrial genomes from both specimens. Both mtDNAs cluster phylogenetically with fallow deer and show high similarity to previously studied partial Megaloceros giganteus DNA from Kamyshlov in western Siberia and Killavullen in Ireland. The unexpected presence of Megaloceros giganteus in Southern Germany after the Ice Age suggests a later survival in Central Europe than previously proposed. The complete mtDNAs provide strong phylogenetic support for a Dama-Megaloceros clade. Furthermore, isotope analyses support an increasing competition between giant deer, red deer, and reindeer after the Last Glacial Maximum, which might have contributed to the extinction of Megaloceros in Central Europe